THE skin lightening craze has escalated over the years that today it is considered a global public health concern due to the negative effects physiologically, psychologically and physically. In April of 2022, the US FDA (United States Food and Drug Authority) issued a warning to twelve companies about skin lightening products which contained unapproved chemicals.

Prelude to this announcement, Medical News Today highlighted an unbiased publication which collated a series of 68 independently funded research projects over a seven year period involving 67,665 participants. This study was published earlier in the International Journal of Dermatology and it had concluded that skin bleaching is a serious global public health issue and warranted public health interventions.

Hence, the WHO (World Health Organisation) suggested restrictive measures and had cautioned against the manufacture, export/ import, sale and consumption of this growing category of products. Despite the advisories, it was predicted that by 2024 this global business will reach US$31 billion since enforcement measures remain a great challenge.

Skin bleaching was found to be predominant in adults over 30 years of age who were only primary schooled, African nationals, both male and female genders with a significant male indulgence and urban and semi-urban residents.

The first country to ban and restrict skin lightening products was South Africa followed by other African countries, South Korea, Asia and the European Union. In 2019 there was a massive seizure of these products in the United Kingdom where fines and first time jail sentence were implemented for offenders involved in the sale of these toxic skin products. However most of these products have been imported through online purchases. It was discovered that one out of two, that is 50 per cent of skin lightening products on Amazon and Ebay, contained mercury.

The skin is the largest organ of the body which acts mainly as a barrier of protection from harmful germs and radiation among other functions. The natural color of the skin is determined by the amount of melanin produced by the melanocytes in the basal layer of the epidermis, the top layer. Chemicals like mercury, when applied, interfere with this mechanism affecting the melanin production and ultimately increasing the likelihood of exposure to harmful ultraviolet radiation, which may lead to skin cancer.

The side effects of skin lightening products vary in severity. Permanent discoloration, facial swelling and rashes are embarrassing and may affect the individual psychologically. Other undesirable effects are thinning of the skin, visibility of blood vessels under the skin and scarring. If applied during pregnancy, abnormalities can be seen in new born babies. A dare price to pay, knowingly or unknowingly, for modifying your natural complexion.

Hydroquinone is one of the approved active ingredients in skin lightening products at a two per cent concentration. It works by reducing the amount of melanin in the skin. Some prescription only option contain hydroquinone in higher concentrations, which are only allowed under supervision of a dermatologist.

The maximum four per cent strength hydroquinone preparation is authorised for use only by a specialist to achieve optimum results in hyperpigmentation of small areas, either due to an injury or medical condition such as acne, sun damage, burns and pregnancy.

The consumers are always cautioned to wear sunscreen during exposure to sunlight, if treated with such agents since there is an associated risk of skin cancer after prolonged exposure to radiation.
Other chemicals like mercury are discovered in the unregulated beauty products presented in the form of creams, lotions, soaps, pills and peels. The active ingredient indicated on the package of some these bleaching agents come under the name calomel, mercurous or mercuric. Mercury is highly toxic to human health. The dangers of using bleaching agents may lead to mercury poisoning such as eye damage, psychiatric problems, difficulty in breathing, nerve problems and kidney problems.

Corticosteroids are another type of prescription only medicine, topical steroids for example clobetasol and betamethasone, which are used irrationally for skin lightening. Prolonged use or exceeding the maximum dosage requirement causes the side effects of thinning the skin, which is perceived as skin lightening. However, what the consumer may not realise is that additional serious side effects are associated with this irrational use including Cushing syndrome, local immunosuppression and hence skin infections (either viral, bacterial or fungal), drug induced diabetes and hypertension and ophthalmic effects such as cataract and glaucoma.

Niacinamide is a different chemical found in this category of products which may be a safer option but may not guarantee even skin toning. Ironically such beauty care products may cause pre-mature aging of the skin as a result from prolonged use.

The prescription only dermatological products are sold country-wide at patent shops or convenient stores without the supervision of a pharmacist hence the fingertip application may not be demonstrated. As in other parts of the developing world, the oversight bodies may lack the resources to enforce the regulations, resulting in unregulated sale in cosmetics stores, beauty sections of supermarkets and shops.

Generally cultural, racial, religious caste systems, social class and most times marketing campaigns associate the color of your skin with superiority. Persons, both males and females with low self-esteem, assume that changing the color of their skin can leverage a life partner or a successful career and hence the way to a perceived happy life.

For further pharmacological guidance, contact the pharmacist of Medicine Express Pharmacy located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.